肝脏原发性癌肉瘤超声造影及术中超声表现1例

Manifestations of contrast-enhanced ultrasound and intraoperative ultrasound of primary liver carcinosarcoma:a case report

患者男,53岁,体检发现肝脏占位1+月入院,既往乙肝病史20+年,右上腹偶有隐痛,无畏寒发热、恶心呕吐等不适。实验室检查:甲胎蛋白(AFP)1188.00 ng/ml,异常凝血酶原(PIVKA-Ⅱ)36.00 mAU/ml,癌胚抗原(CEA)、CA19-9及CA-125均正常。术前超声检查:肝脏形态大小未见异常,实质回声粗糙、不均匀,左内叶查见大小约3.0 cm×2.3 cm的团状稍强回声(图1),边界欠清楚,形态欠规则,内可见小片状低回声区。超声造影检查:该团块动脉相呈高增强(图2),门脉相呈轻度低增强(图3),实质相呈低增强(图4),考虑多为肝细胞肝癌。增强CT检查:团块密度不均匀,动脉期轻度强化(图5),门脉期强化降低。